What is spinal cord injury?The spinal cord is an elongated and cylinder-shaped collection of nerves that arise from the end of the brain and extends into the neck and back region. It forms a primary communication channel between the brain and the body. Injury to the delicate spinal cord or its surroundings is known as a spinal cord injury.
What is the prevalence of spinal cord injury?The World Health Organization estimates that about 2-5 lakh people suffer a spinal cord injury every year, primarily attributed to accidents or trauma. A spinal cord injury increases the risk of death by 2-5 folds in the general population, making it a serious medical issue. The prevalence of spinal cord injuries is estimated to be about 1.5 million in India, with an increase of 20,000 cases, year on year.
What causes spinal cord injury?The most common cause of spinal injury is trauma owing to,
- Vehicular or road accidents
- Sports injury
- Deterioration of the spine
- Congenital disabilities
- Injury during birthing
Who are at risk of spinal cord injury?Anyone who is at a higher risk for of injury is at high risk for spinal cord injuries.
- People who have smaller than regular spinal cords are also at a higher risk for spinal cord injury
- Engaging in risky behavior, sportspersons, and the presence of a bone disorder may also increase the risk of spinal cord injury
What are the types of spinal cord injury?Based on severity
- Complete: A result of a severe injury leading to complete loss of sensation and movement below the site of injury
- Incomplete: A result of injury leading to a partial loss of sensation and movement below the site of injury
- Tetraplegia: A severe type of spinal cord injury wherein there is a loss of sensation, function or movement in the head, neck, arms, hands, shoulders, upper chest or legs, impacting daily functions.
- Paraplegia: Loss of sensation, function or movement in the legs or lower parts of the body.
- Triplegia: Loss of sensation and movement in one arm and both legs, and is usually seen in incomplete spinal cord injury
The American Spinal Injury Association (ASIA) classifies spinal cord injuries into the following types
- ASIA A: A complete spinal cord injury with complete loss of movement and sensation
- ASIA B: A complete spinal cord injury with complete loss of movement
- ASIA C: An incomplete spinal cord injury with limited movement preserved, with less than half muscles are unable to lift extremities
- ASIA D: An incomplete spinal cord injury with limited movement preserved, with more than half muscles are unable to lift extremities
- ASIA E: Normal movement and sensation preserved
What are the symptoms of spinal cord injury?The symptoms of spinal cord injury depend on the type, degree and level of injury and hence can be extremely variable. However, some of the common symptoms that suggestion a spinal cord injury include:
- Loss of movement
- Loss or tingling sensation, including the ability to feel heat, cold and touch
- Loss of bowel or bladder control
- Exaggerated muscle movement or spasms
- Changes in sexual function, sexual sensitivity and fertility
- Pain or an intense stinging sensation
- Difficulty breathing or coughing
- Balance issues
How is spinal cord injury diagnosed?The symptoms of a spinal cord injury may not be evident immediately post the damage and hence needs immediate medical attention to identify the problem and its extent. The immediate step is the assessment of breathing and pulse rate, to ensure the patient is stable. Commonly, a comprehensive medical history and physical examination help identify the areas of movement and sensation loss. The area of the spinal cord injury is generally immobilised using medical equipment like collars. Moreover, a few tests help take pictures of the site of injury and confirm the condition. They help in identifying fractures, abnormalities, blood clots and masses among others. The routine assessments include:
- Blood test
- CT scan
- MRI scan